Please complete this application online or print it out and fax it to 212. 627.2251
Name:
Date of Birth:
Address:
Address line2:
City:
State:
Country:
Zip/Postal Code:
Phone Number:
Email Address:
Emergency Contact Name:
Emergency Contact Phone:
About You
What style of yoga do you practice?
Where?
With whom?
For how long?
How many times a week?
Do you have a home practice?
Do you practice meditation and/or pranayama?
Please tell us about your health: injuries, conditions, illnessess
Please list any medications you are taking
Are you pregnant?
Is this your first teacher training?
Are you currently teaching yoga?
If yes, where? For how long?
In your opinion what embodies a good yoga teacher?
Why do you want to take the joschi teacher training?
What are your expectations of the joschi teacher training?
What do you hope to learn?
Registration and Credit Card
Authorization Agreement
I understand Joschi Yoga Institue will review my application and
notify me of acceptance as soon as possible.
$1000 on acceptance date
$650 1 month before start date
$600 15 days before start date
At least 1 month prior to start date
$2,350
SAVE $200
$1,500 on acceptance date
$850 15 days before start date
Thereafter
$2,550
on acceptance date
Enjoy UNLIMITED YOGA CLASSES during the duration of your Teacher Training program.
Credit Card Information
Credit Card Type:
Name on Card:
Credit Card Number:
Expiration Date:
Month
Year
Billing Address:
By clicking YES below I authorize Joschi International, Inc.
to initiate credit card debit entries for tuition payment according to the schedule set forth above. I further understand and agree that each payment is non-refundable.
Yes
No
Joschi Yoga Institute
163
West 23rd Street
5th Floor
New York, NY 10011
Telephone and Fax
phone: 212.399.6307
fax: 212.627.2251
